New book offers insights on future of the Dutch euthanasia practice

In his new book, Buijsen targets an international readership interested in the legal and moral aspects of end-of-life decisions. He highlights how the Netherlands has shaped euthanasia policy and how this takes shape in practice. The book is not only a valuable reference work for academics and students, but also an essential teaching book that will be used in several legal, medical and health science master's programmes, including the Erasmus School of Law master's programme in Healthcare Law. 

The drivers behind the policy

Buijsen emphasises that Dutch euthanasia policy is primarily founded on compassion. Buijsen: "It is very important to understand that this policy is ultimately founded on compassion, rather than - as people tend to think abroad - on something like individual self-determination." Dutch law has long recognised that a doctor who proceeds to end a patient's life at the patient's request should, under certain conditions, be discharged from prosecution. "In Dutch law, there has been found room for understanding such deliberate life-ending acts as an act of compassion, a form of compassion reserved for doctors", Buijsen said. "Such a doctor can invoke force majeure in the sense of a state of emergency if he finds himself placed in a situation of conflict of duties, the duty to preserve the patient's life on the one hand and relieve his suffering on the other, and chooses the latter at the expense of life. Does the doctor report that action and has observed certain requirements of care in doing so, the doctor remains immune from criminal prosecution."

The future of euthanasia policy

Buijsen foresees that Dutch euthanasia policy will continue to be based on the current regulatory concept: criminalisation, a special ground for punishment coupled with due diligence requirements, a duty to report and retrospective review. Over the years, this concept has been applied analogously in other areas of deliberate termination of life, such as with severely suffering newborns and recently extended to patients up to the age of 12. However, Buijsen notes that further expansion, such as the proposal by Uit Vrije Wil for the elderly with no medical basis, is unlikely to be successful within the current legal framework. "Of legal rules with the explicit objective of facilitating assisted suicide for elderly people in whom there is no suffering based on a medical basis, I do not see it coming any time soon", Buijsen said.

A critical look at the guiding country

Although the Netherlands is often seen as a guiding country on euthanasia, Buijsen argues that the successful analogous applications of the regulatory concept are legally problematic. Arrangements such as those for severely suffering newborns and children up to 12 years of age lack a solid legal basis and may be incompatible with the European Convention on Human Rights (ECHR). Buijsen points out that while the right of anyone to decide how and when to end their own life is recognised by the ECHR, Dutch law places restrictions that are intended to protect vulnerable people. “A state may place restrictions on the exercise of that right, and that is what the Netherlands has done with Euthanasia Act. But the 'margin of appreciation' is very wide and there is no doubt that the Euthanasia Act is compatible with the ECHR”, Buijsen argued.